Dobson John L, Yarbrough Mary Beth, Perez Jose, Evans Kelsey, Buckley Thomas
School of Health and Kinesiology, Georgia Southern University, Statesboro, Georgia;
School of Health and Kinesiology, Georgia Southern University, Statesboro, Georgia.
Am J Physiol Regul Integr Comp Physiol. 2017 Apr 1;312(4):R575-R584. doi: 10.1152/ajpregu.00499.2016. Epub 2017 Feb 1.
Recent evidence suggests that concussions may disrupt autonomic cardiovascular control. This study investigated the initial effects of concussion on cardiovascular function using three autonomic reflex tests. Twenty-three recreational athletes (12 women, 11 men) were divided into concussed ( = 12) and control ( = 11) groups. Concussed participants performed forced breathing, standing, and Valsalva autonomic tests four times: ) within 48 h of injury; ) 24 h later; ) 1 wk after injury; and ) 2 wk after injury. The controls performed the same tests on the same schedule. Differences in heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) responses to the tests were continuously measured using finger photoplethysmography and were analyzed using repeated-measures multivariate ANOVAs and ANOVAs. Within 48 h of injury, the concussed group had significantly greater resting SBP ( = 2.44, = 0.02, = 1.03), HR ( = 2.33, = 0.03, = 1.01), and SBP responses to standing ( = 2.98, = 0.01, = 1.24), and 90% SBP normalization times ( = 2.64, = 0.02, = 1.10) after the Valsalva, but those group differences subsided 24 h later. There was also a significant interaction with the HR responses to forced breathing ( = 4.13, = 0.01, η = 0.17), indicating the concussed responses declined relative to the control's over time. The results demonstrate that concussion disrupted autonomic cardiovascular control, and that autonomic reflex tests are practical means by which to evaluate that dysfunction.
近期证据表明，脑震荡可能会扰乱自主心血管控制。本研究使用三项自主反射测试，调查了脑震荡对心血管功能的初始影响。23名休闲运动员（12名女性，11名男性）被分为脑震荡组（n = 12）和对照组（n = 11）。脑震荡参与者在受伤后48小时内、24小时后、受伤后1周和受伤后2周进行了四次强迫呼吸、站立和瓦尔萨尔瓦自主测试。对照组按照相同的时间表进行相同的测试。使用手指光电容积描记法持续测量测试中心率（HR）、收缩压（SBP）和舒张压（DBP）反应的差异，并使用重复测量多元方差分析和方差分析进行分析。在受伤后48小时内，脑震荡组的静息SBP（F = 2.44，p = 0.02，η² = 1.03）、HR（F = 2.33，p = 0.03，η² = 1.01）以及站立后的SBP反应（F = 2.98，p = 0.01，η² = 1.24）和瓦尔萨尔瓦动作后的90% SBP恢复正常时间（F = 2.64，p = 0.02，η² = 1.10）均显著更高，但这些组间差异在24小时后消失。在强迫呼吸时的HR反应方面也存在显著交互作用（F = 4.13，p = 0.01，η² = 0.17），表明随着时间推移，脑震荡组的反应相对于对照组有所下降。结果表明，脑震荡扰乱了自主心血管控制，并且自主反射测试是评估该功能障碍的实用手段。
